Use of Last-Resort Antibiotics Rises in VA Hospitals, National Study Finds

3:52 May 17, 2012

(WASHINGTON)–To fight a rising number of drug-resistant infections, doctors in VA hospitals are increasingly turning to suboptimal last-resort antibiotics in the absence of effective alternatives. A study in the journal PLoS One looks at the use of drugs known as polymyxins, which were discovered more than 50 years ago, but went out of favor because they can cause serious kidney damage.

“Doctors are typically quite reluctant to use polymyxins. We only reach for them when we have no other choice,” said Dr. Makoto Jones, one of the study authors and an assistant professor of internal medicine at the University of Utah School of Medicine.

Despite this common reluctance to prescribe polymyxins, Jones and his colleagues found that their use increased by 25 percent between 2005 and 2010. The data was derived from detailed electronic records from individual patients at 127 VA centers over the five-year period. The paper also found a more than four-fold increase in use of another antibiotic called tigecycline, which is also used to treat multidrug-resistant infections.

“The absence of new safe and effective antibiotics to treat serious and life-threatening infections is a particular cause for concern,” the authors wrote in the PLoS One article, entitled, “Drugs of Last Resort? The Use of Polymyxins and Tigecycline at U.S. Veterans Affairs Medical Centers, 2005-2010.”

This study bolsters anecdotal evidence reported by physicians. According to a 2011 survey of 562 infectious diseases doctors conducted via the Emerging Infections Network and recently published in the journal Clinical Infectious Diseases, 64 percent have prescribed polymyxins within the past year. Sixty-three percent of respondents reported caring for a patient with an infection resistant to all available antibacterials and 56 percent believed that the number of these untreatable infections is increasing.*

“We need policies to overcome the challenges stifling the development of new antibiotics,” said Sharon Ladin, director of the Pew Health Group’s Antibiotics and Innovation Project, which funded the study. “These hard to treat infections are a special threat for the many military personnel who suffer infections after sustaining injuries in combat.”

The Pew Health Group’s Antibiotics and Innovation Project provided funding for the paper. It is advocating for measures to incentivize the development of new antibiotics. It has called on Congress to include in its reauthorization of the Prescription Drug User Fee Act of 2012 the provisions that comprised the Generating Antibiotic Incentives Now Act (H.R. 2182, S. 1734), bipartisan legislation that would provide companies developing drugs to treat serious and life-threatening bacterial infections with an extra five years of exclusive rights to market those products.

About Pew Health Group Based on data, science, and non-partisan research, the Pew Health Group works to reduce hidden risks to the health, safety, and well-being of American consumers. We are focused on ensuring transparency and giving people the tools they need to lead better lives and make healthier decisions. Working closely with industry, government, impartial experts, and a wide range of consumer groups, we develop and promote practical solutions to problems that impact human health, whether they be in the foods we eat, the drugs we take, or many of the consumer products we use every day.

The Antibiotics and Innovation Project addresses the growing public health challenge of multidrug-resistant infections by supporting policies that stimulate and encourage the development of antibiotics to treat life-threatening illnesses.

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